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Cited by 637

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

Homeostasis Model Assessment of Insulin Resistance in Relation to the Incidence of Cardiovascular Disease

Open access
Hanley, Anthony J.G., Williams, Ken, Stern, Michael P., Haffner, Steven M.·2002·Diabetes Care
DOI 10.2337/diacare.25.7.1177
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Abstract

OBJECTIVE—The prospective association between insulin levels and risk of cardiovascular disease (CVD) is controversial. The objective of the present study was to investigate the relationship of the homeostasis model assessment of insulin resistance (HOMA-IR), as well as insulin levels, with risk of nonfatal and fatal CVD over the 8-year follow-up of the San Antonio Heart Study. RESEARCH DESIGN AND METHODS—Between 1984 and 1988, randomly selected Mexican-American and non-Hispanic white residents of San Antonio participated in baseline examinations that included fasting blood samples for glucose, insulin, and lipids, a glucose tolerance test, anthropometric measurements, and a lifestyle questionnaire. Between 1991 and 1996, 2,569 subjects who were free of diabetes at baseline were reexamined using the same protocol. RESULTS—Over the follow-up period, 187 subjects experienced an incident cardiovascular event (heart attack, stroke, heart surgery, angina, or CVD death). Logistic regression analysis indicated that risk of a CVD event increased across quintiles of HOMA-IR after adjustment for age, sex, and ethnicity (P for trend <0.0001; quintile 5 vs. quintile 1, odds ratio [OR] 2.52, 95% CI 1.46–4.36). Additional adjustment for LDL, triglyceride, HDL, systolic blood pressure, smoking, alcohol consumption, exercise, and waist circumference only modestly reduced the magnitude of these associations (P for trend 0.02; quintile 5 vs. quintile 1, OR 1.94, 95% CI 1.05–3.59). Furthermore, there were no significant interactions between HOMA-IR and ethnicity, sex, hypertension, dyslipidemia, glucose tolerance (impaired glucose tolerance versus normal glucose tolerance), or obesity. The magnitude and direction of the relationship between insulin concentration and incident CVD were similar. CONCLUSIONS—We found a significant association between HOMA-IR and risk of CVD after adjustment for multiple covariates. The topic remains controversial, however, and additional studies are required, particularly among women and minority populations.

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Metadata

Authors
Hanley, A. J. G., Williams, K., Stern, M. P., & Haffner, S. M.
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2002-07-01
Volume
25
Issue
7
Pages
1177-1184
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.25.7.1177
OpenAlex
W2005052233
Cited by
637
References
6
FWCI
15.94
Type
journal article
Language
en
Open access
bronze

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